type: depends-on

Resource:
reference: Library/library-fhir-helpers

type: depends-on

Resource:
reference: Library/library-common-FHIR

library EXM146_FHIR version '4.0.0'

/*
This example is a work in progress and should not be considered a final specification
or recommendation for guidance. This example will help guide and direct the process
of finding conventions and usage patterns that meet the needs of the various stakeholders
in the measure development community.
*/

using FHIR version '3.0.0'

include FHIRHelpers version '3.0.0' called FHIRHelpers
include Common_FHIR version '2.0.0' called Common

valueset "Acute Pharyngitis": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1011'
valueset "Acute Tonsillitis": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1012'
valueset "Ambulatory/ED Visit": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1061'
valueset "Antibiotic Medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1001'
valueset "Group A Streptococcus Test": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1012'

parameter "Measurement Period" Interval<DateTime>

context Patient

// Region: Initial Population

define "In Demographic":
  AgeInYearsAt(start of "Measurement Period")>= 2
    and AgeInYearsAt(start of "Measurement Period")< 18

define "Antibiotics":
  [MedicationRequest: medication in "Antibiotic Medications"] Prescription
    where Prescription.status = 'active'
      and Prescription.intent = 'order'

define "Pharyngitis":
  ( [Condition: code in "Acute Pharyngitis"]
    union [Condition: code in "Acute Tonsillitis"] ) Pharyngitis
    where Pharyngitis.clinicalStatus = 'active'
      and Pharyngitis.verificationStatus = 'confirmed'

define "Measurement Period Encounters":
  [Encounter: "Ambulatory/ED Visit"] Encounter
    where Encounter.period during "Measurement Period"
      and Encounter.status = 'finished'
      and "In Demographic"

define "Pharyngitis Encounters With Antibiotics":
  "Measurement Period Encounters" Encounters
    with "Pharyngitis" Pharyngitis
      such that Common."Includes Or Starts During"(Pharyngitis, Encounters)
    with "Antibiotics" Antibiotics
      such that Antibiotics.authoredOn 3 days or less after FHIRHelpers.ToInterval(Encounters.period)

define "Initial Population":
  "Pharyngitis Encounters With Antibiotics"

// EndRegion: Initial Population

// Region: Denominator

// None

// EndRegion: Denominator

// Region: Denominator Exclusions

define "Pharyngitis With Prior Antibiotics":
  "Pharyngitis" Pharyngitis
    with "Antibiotics" Antibiotics
      such that Antibiotics.authoredOn 30 days or less before Pharyngitis.onset

define "Excluded Encounters":
  "Pharyngitis Encounters With Antibiotics" Encounters
    with "Pharyngitis With Prior Antibiotics" Pharyngitis
      such that Common."Includes Or Starts During"(Pharyngitis, Encounters)

define "Denominator Exclusions":
  "Excluded Encounters"

// EndRegion: Denominator Exclusions

// Region: Denominator Exceptions

// None

// EndRegion: Denominator Exceptions

// Region: Numerator

define "Strep Test Encounters":
  "Pharyngitis Encounters With Antibiotics" Encounters
    with [Observation: code in "Group A Streptococcus Test"] Tests
      such that Tests.value is not null
        and Tests.effective starts during Interval[start of FHIRHelpers.ToInterval(Encounters.period)- 3 days, 
        end of FHIRHelpers.ToInterval(Encounters.period)+ 3 days]

define "Numerator":
  "Strep Test Encounters"

// EndRegion: Numerator

// Region: Numerator Exclusion

// None

// EndRegion: Numerator Exclusion